Sex differences in upper limb vascular complications following transradial cardiac catheterization. A sub-study of the LOW-RAO study
S Tsokkou, A Keramas, A Pagiantza, C S Kakderis, S Daios, E Peteinidou, K Lekka, K C Theodoropoulos, A Kouparanis, T Papamitsou, V Kamperidis, G Kassimis, A Ziakas, M DidagelosAbstract
Background
Transradial access has become the preferred approach for coronary angiography and percutaneous coronary intervention due to its safety profile. However, the influence of sex on upper limb vascular complications remains under investigation.
Purpose
To evaluate whether sex is associated with differences in early upper limb vascular complications following transradial cardiac catheterization.
Methods
A total of 769 consecutive adult patients (mean age 65±12 years, 22% females), undergoing transradial coronary angiography and/or percutaneous coronary intervention that were screened for the LOW-RAO study were analyzed. Upper limb vascular complications within 24 hours were systematically recorded and compared between males and females.
Results
Of the total cohort, 600 patients (78%) were male and 169 (22%) females. Forearm bleeding was significantly more frequent in females compared with males (10.5% vs 3.8%, p=0.0015). No statistically significant differences were observed between sexes for RAO (p=0.296), hematoma (p=0.404), pain (p=0.073), paresthesia (p=0.409), non-palpable radial pulse (p=0.680), negative reverse Allen (p=0.988), negative reverse Barbeau (p=1.000), or other limb complications.
Conclusion
Female sex was associated with a higher incidence of early hemorrhagic complications following transradial access, whereas thrombotic and ischemic complications did not differ significantly between sexes. These findings suggest that bleeding risk mitigation strategies may be particularly relevant in female patients undergoing transradial procedures.RESULTS TABLEFor image description, please refer to the figure legend and surrounding text.